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Liu T, Jia C, Li Y. Treatment of sexual dysfunction induced by hyperprolactinemia accompanied by reduced luteinizing hormone levels: A case report. Clin Case Rep 2024; 12:e8432. [PMID: 38435507 PMCID: PMC10901787 DOI: 10.1002/ccr3.8432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/20/2023] [Accepted: 12/24/2023] [Indexed: 03/05/2024] Open
Abstract
Key Clinical Message Sexual dysfunction induced by hyperprolactinemia accompanied by reduced luteinizing hormone (LH) is common in anrology clinics. A low dose of bromocriptine is helpful for restoring penile erectile function and libido in patients. Abstract Sexual dysfunction is closely related to hormonal disorders, of which prolactin (PRL) and luteinizing hormone (LH) disorders are common. How to treat sexual dysfunction induced by hyperprolactinemia accompanied by reduced LH levels is worth discussing. In this study, we aimed to present the case of a 35-year-old male patient with sexual dysfunction. The treatment process and physical and laboratory examination results were recorded. Before treatment, the PRL and LH levels in this patient were 31.27 ng/mL and 1.62 mIU/mL, respectively. The International Index of Erectile Function-5 (IIEF-5) score was initially 14 points. After regular treatment with low doses of bromocriptine and tadalafil, the hormonal disorder was corrected (PRL: 11.16 ng/mL and LH: 2.28 mIU/mL) and sexual function was recovered (IIEF-5: 23 points). This case report suggested a sufficient exposure to low-dose bromocriptine for such patients. Conversely, the exogenous supplementation of human chorionic gonadotropin may not be appropriate.
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Affiliation(s)
- Tao Liu
- Sexual Department, First Affiliated HospitalWannan Medical CollegeWuhuChina
| | - Chao Jia
- Sexual Department, First Affiliated HospitalWannan Medical CollegeWuhuChina
| | - Yan Li
- Sexual Department, First Affiliated HospitalWannan Medical CollegeWuhuChina
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Shettima FB, Wakil MA, Sheikh TL, Abdulaziz M, Wakawa IA, Beida O. Antipsychotics-related hyperprolactinaemia among patients with schizophrenia in Maiduguri. S Afr J Psychiatr 2024; 30:2133. [PMID: 38444408 PMCID: PMC10912972 DOI: 10.4102/sajpsychiatry.v30i0.2133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/10/2023] [Indexed: 03/07/2024] Open
Abstract
Background Hyperprolactinaemia among patients on antipsychotic medications is generally overlooked due to lack of outwardly visible symptoms, patient resistance to reporting because the symptoms are perceived as shameful, or to clinician's insufficient knowledge. Aim The study aimed to evaluate the patterns and correlates of hyperprolactinemia among patients with schizophrenia on antipsychotic medications. Setting The study was conducted in a psychiatric facility in Maiduguri, Northeastern Nigeria. Methods A total of 209 patients with schizophrenia were evaluated through a cross-sectional design and assayed for serum prolactin with ELISA Kits. Frequencies and percentages were tabulated for categorical variables. Variables with significant associations with hyperprolactinaemia on chi-square (p < 0.05) were subjected to logistic regression analysis. Results The prevalence of hyperprolactinaemia was 45.9% in all patients on antipsychotic medication. The prevalence because of the use of typical and atypical antipsychotics was 51.5% and 25.0%, respectively. Hyperprolactinaemia was significantly associated with typical antipsychotics (β = 0314, p = 0.002), high overall drug dosage (β = 2.340, p = 0.003), high-dose typical antipsychotics (β = 3.228, p = 0.000), twice daily dosing frequency (β = 2.751, p = 0.001) and polypharmacy (β = 1.828, p = 0.0024). Conclusion The findings support that patients on typical, high-dose antipsychotic medications and polypharmacy have a high prevalence of hyperprolactinaemia. As hyperprolactinaemia is often undetectable, screening and patient psycho-education on the significance of the signs and symptoms of hyperprolactinaemia is required for necessary clinical intervention. Contribution The study provides evidence for the rational use of antipsychotic medications in sub-Saharan Africa.
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Affiliation(s)
- Falmata B Shettima
- Department of Mental Health, Faculty of Psychiatry, Federal Neuropsychiatric Hospital, Maiduguri, Nigeria
| | - Musa A Wakil
- Department of Mental Health, Faculty of Psychiatry, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
| | - Taiwo L Sheikh
- Department of Mental Health, Faculty of Psychiatry, Ahmadu Bello University Zaria, Kaduna, Nigeria
| | - Mohammed Abdulaziz
- Department of Mental Health, Faculty of Psychiatry, Federal Neuropsychiatric Hospital Kaduna, Kaduna, Nigeria
| | - Ibrahim A Wakawa
- Department of Mental Health, Faculty of Psychiatry, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
| | - Omeiza Beida
- Department of Mental Health, Faculty of Psychiatry, Federal Neuropsychiatric Hospital Kaduna, Kaduna, Nigeria
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Zhuo C, Xu Y, Wang H, Fang T, Chen J, Zhou C, Li Q, Liu J, Xu S, Yao C, Yang W, Yang A, Li B, Chen Y, Tian H, Lin C. Safety and Efficacy of High-Dose Vitamin B6 as an Adjunctive Treatment for Antipsychotic-Induced Hyperprolactinemia in Male Patients With Treatment-Resistant Schizophrenia. Front Psychiatry 2021; 12:681418. [PMID: 34512411 PMCID: PMC8426548 DOI: 10.3389/fpsyt.2021.681418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/05/2021] [Indexed: 12/28/2022] Open
Abstract
This study aimed to investigate the safety and efficacy of high-dose vitamin B6 (vB6) as an adjunct treatment for antipsychotic-induced hyperprolactinemia (AIHP) in male patients with treatment-resistant schizophrenia (TRS). In this randomized double-blinded controlled study, patients were randomized (1:1) into a control group given aripiprazole (ARI; 10 mg/day; n = 100) or an intervention group given vB6 (300 mg/12 h for 16 weeks; n = 100). Prolactin levels, psychotic symptoms [Positive and Negative Syndrome Scale (PANSS)], cognitive function [MATRICS Consensus Cognitive Battery (MCCB)], liver function, kidney function, growth hormone level, micronutrient levels, blood lipids, and adverse secondary effects (ASEs)[Treatment Emergent Symptom Scale (TESS) and Barnes-Akathisia scale] were monitored. After a 16-week treatment period, the vB6 group showed a 68.1% reduction in serum prolactin levels (from 95.52 ± 6.30 μg/L to 30.43 ± 18.65 μg/L) while the ARI group showed only a 37.4% reduction (from 89.07 ± 3.59 μg/L to 55.78 ± 7.39 μg/L). During weeks 1-4, both treatments reduced prolactin similarly. Subsequently, the ARI effect plateaued, while the vB6 effect remained robust. The vB6 group showed better alleviation of psychotic symptoms and cognitive impairment. No serious ASEs were observed; ASEs were more frequent in the ARI group. AIHP reduction efficacy of vB6 was associated with baseline prolactin and triglyceride levels, total vB6 dosage, and education level. In conclusion, compared with the ARI group, TRS patients given vB6 showed better attenuation of AIHP, lower ASE scores, and greater improvements in clinical symptoms and cognitive impairments. These results support further consideration of vB6 as a putative treatment for AIHP. Trial Registration: ChiCTR1800014755.
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Affiliation(s)
- Chuanjun Zhuo
- Key Laboratory of Multiple Organ Damages of Major Psychoses (MODMP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China.,Key Laboratory of Real Time Brain Circuit Tracing in Neurology and Psychiatry (RTBNP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Mental Disorder Therapy Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Haibo Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Tao Fang
- Key Laboratory of Multiple Organ Damages of Major Psychoses (MODMP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China.,Key Laboratory of Real Time Brain Circuit Tracing in Neurology and Psychiatry (RTBNP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China
| | - Jiayue Chen
- Key Laboratory of Real Time Brain Circuit Tracing in Neurology and Psychiatry (RTBNP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China.,Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital Affiliated to Hebei Medical University, Shijiazhuang, China
| | - Qianchen Li
- Department of Pharmacology, The First Hospital Affiliated to Hebei Medical University, Shijiazhuang, China
| | - Jie Liu
- Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Shuli Xu
- Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Cong Yao
- Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Weiliang Yang
- Laboratory of Neuro-Imaging and Comorbidity (PNGC_Lab), Tianjin Anding Hospital Affiliated to Nankai University, Tianjin Medical University, Tianjin, China
| | - Anqu Yang
- Department of Treatment Resistant Schizophrenia, Tianjin Kangtai Hospital, Tianjin, China
| | - Bo Li
- Department of Treatment Resistant Schizophrenia, Tianjin Kangtai Hospital, Tianjin, China
| | - Yuhui Chen
- Department of Treatment Resistant Schizophrenia, Tianjin Kangtai Hospital, Tianjin, China
| | - Hongjun Tian
- Key Laboratory of Multiple Organ Damages of Major Psychoses (MODMP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China.,Key Laboratory of Real Time Brain Circuit Tracing in Neurology and Psychiatry (RTBNP_Lab), Tianjin Fourth Center Hospital, The Fourth Central Hospital Affiliated With Nankai University, The Fourth Central Hospital Affiliated to Tianjin Medical University, Tianjin, China
| | - Chongguang Lin
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
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